JBC approves phase‑3 Accountable Care Collaborative pilot with limited assumed savings; requests department comeback

The Joint Budget Committee voted to approve staff recommendations for phase 3 of the Accountable Care Collaborative (ACC), but members limited the amount of savings the committee would assume when balancing the budget and asked the Department of Health Care Policy and Financing (HCPF) to return with more detail.

Joseph (Joe) Kurtz, Health Care Policy and Financing staff, presented R6 and described the proposal’s main components: increased contractual responsibilities for RAE/RAISE entities on transitions-of-care and practice-transformation supports, a proposed statewide broker for nonemergency medical transportation, expanded credentialing centralization, and outreach/communication costs. Kurtz said the department requested roughly $10.2 million general fund in FY 2025–26 and $12.3 million general fund in FY 2026–27 for the phase-3 implementation.

Kurtz cautioned the committee that a portion of the department’s projected savings—chiefly from reduced adult readmissions tied to transitions-of-care—are uncertain and may take time to materialize. He noted that a cited North Carolina study showed statistically significant reductions only after 12 months. Kurtz told the committee he would not recommend assuming the department’s full adult savings projection for balancing; instead, staff recommended either assuming no savings or a conservative amount.

After debate, the committee adopted staff recommendation to approve implementation resources but agreed to assume $5,000,000 in general-fund savings (a partial, conservative assumption) rather than the full adult savings the department forecasted. The motion to approve the package with the $5 million assumed savings passed 5–1, with Senator Kirkmeyer recorded as objecting. Members asked the department and the RAEs to prepare a detailed comeback explaining how savings will be tracked, the timeline for expected results, and what would happen if savings do not materialize as projected.

Why it matters: The ACC phase‑3 changes aim to tighten care coordination during transitions from institutional to community settings and to build practice-transformation supports in underserved regions. Implementation could improve continuity of care for high-need members and reduce avoidable hospital utilization, but the budgetary effect depends on whether the projected reductions in utilization materialize.

Ending: The committee’s vote allows the department to begin phase‑3 implementation planning while requiring HCPF to return with more detailed analyses and a plan to validate any assumed savings.